Spectacle use after routine cataract surgery
Spectacle use after routine cataract surgery
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DOI：
10.1136/bjo.2008.151829
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发表时间：
2009-10-01
影响因子：
4.1
通讯作者：
Rubin, G.
中科院分区：
文献类型：
--
作者：
Wilkins, M. R.;Allan, B.;Rubin, G.
目的：目的：探讨双侧单焦点人工透镜（IOL）植入术后的眼镜依赖性，并评估其与术后屈光度的关系。目标球镜当量为0至-0.5 D。手术后三个月，患者回答了一份问卷，并进行了眼镜验光。折射被转换成矢量符号。采用Logistic回归分析近视和远距离眼镜依赖与总屈光不正、球镜误差、符号球镜误差和屈光不正的关系。38人戴远距眼镜，160人部分或全部时间戴阅读眼镜。平均右等效球镜为-0.03 D，平均右柱镜为-0.64 D。左侧结局相似。患者总是使用远距眼镜的可能性是较好眼睛的屈光度的34倍（p < 0.003），但佩戴远距眼镜的可能性没有显著增加（比值比= 3.85，p > 0.15）。对于较好和较差的眼睛，观察到类似的效果。近视眼镜的使用不依赖于屈光不正（优势比= 0.22，p > 0.12）。它只与屈光度差的患眼的符号球镜误差有关，每屈光度的正球镜误差使远视患者经常戴眼镜的可能性增加6.74倍（p < 0.005）。双侧单焦点人工透镜植入后，任一眼的小水平总体屈光不正，特别是散光，预示着距离-眼镜依赖性，而在+/-1.0D范围内的球面屈光不正则没有。屈光不好的眼睛的上斜视，而不是散光，预示着阅读眼镜依赖。
Aims: To measure spectacle dependence following bilateral monofocal intraocular lens (IOL) implantation and assess how it is predicted by postoperative refraction.Methods: 300 cataract patients had bilateral phacoemulsification surgery with monofocal IOL implantation. A spherical equivalent of 0 to -0.5 D was targeted. Three months after surgery, patients answered a questionnaire and had a spectacle refraction. Refractions were converted into vector notation. Logistic regression was used to evaluate whether spectacle dependence for near and distance was related to overall refractive error, spherical error, signed spherical error and astigmatic error.Results: 169 patients attended for assessment. 38 wore distance glasses, and 160 wore reading glasses either some or all of the time. The mean right spherical equivalent was -0.03 D, and the mean right cylinder was -0.64 D. Left outcomes were similar. Patients were 34 times more likely to always use distance glasses per dioptre of astigmatic error in the better eye (p < 0.003), but there was no significant increase in the likelihood of wearing distance glasses with spherical error (odds ratio = 3.85, p > 0.15). Similar effects were seen for both the better and worse eyes. Near-spectacle use was not dependent on astigmatic error (odds ratio = 0.22, p > 0.12). It was only related to the signed spherical error in the worse eye with hypermetropic patients 6.74 times more likely to always wear spectacles per dioptre of positive spherical error (p < 0.005).Conclusions: Following bilateral monofocal intraocular lens implantation, small levels of overall refractive error, in either eye, particularly astigmatism, predict distance-spectacle dependence, whereas spherical ammetropia in the range of +/- 1.0 D does not. Hypermetropia in the worse eye, but not astigmatism, predicts reading-spectacle dependence.